Ukwahlukanisa ukukhuluphala. Izimbangela, izimpawu, ukuxilongwa kanye nokwelashwa ukukhuluphala

Omunye wezinkinga zomphakathi kule kwekhulu lamashumi amabili nanye isibe okhuluphele. Lesi sifo "ukuqasha" abasekeli bawo entsha emhlabeni wonke. Lokhu kungenxa ukudla okungenamsoco, yokuphila umzimba, nabaningi ezingamahlalakhona endocrine pathologies kanye nezinye izinto eziningi. Ngokwezwi nezwi igama elithi ukukhuluphala kusho ukuthi isisindo is ukhulise ngenxa imisipha kokucindezelwa, kodwa ngezithukuthuku imali fat ezingxenyeni ezihlukahlukene zomzimba. Nezingozi ukukhuluphala ngokweqile? Bheka abantu abakhuluphele noma yimuphi udokotela Uyobiza izizathu kweshumi, futhi kwasekuqaleni kuyoba isifo inhliziyo, imithambo yegazi, amalunga amathambo, ukuhlukumeza yamanzi-usawoti umzimba. Ngaphezu kwalokho, lesi sifo singumbulali nzima ukuzwana nabantu, njengoba emphakathini wanamuhla ubuswa Amathrendi kwezemidlalo futhi enempilo.

omsakazo

Lesi sifo "ukukhuluphala" ingatholakala yezizathu ezihlukahlukene. I osobala kakhulu ukungawuvivinyi umzimba, lapho-ke kuyinto nokungahambisani phakathi kilojoule kokuthola nokusaphaza amandla. Imbangela yesibili ezivamile isisindo okweqile kungukuphula pheshana emathunjini. Lokhu kungaba kusimo enzyme pancreatic, wokwehla isibindi, izinkinga ukugaya ukudla. Ngaphezu kwalokho, ingozi ukukhuluphala kungaba determinate ezakhini zofuzo.

Kukhona okuyizici ezinomthelela kwesisindo lezi zibandakanya:
- ukusetshenziswa iziphuzo okunoshukela noma Ukudla aqukethe omningi;
- endocrine izifo ezifana hypogonadism, i-hypothyroidism, amanyikwe isimila;
- iziyaluyalu ezingokwengqondo (yokuphazamiseka kwemikhuba yokudla);
- ukucindezeleka unomphela nokungalali;
- hormone noma izidakamizwa psychotropic.

Evolution waqopha eminyakeni 2 million uye walungiselela indlela wayenemfuyo izakhi uma ngokungazelelwe ugijima esifushane ukudla. Futhi uma lokho kuyiqiniso ngoba abantu basendulo, lendoda wanamuhla akudingeki "engcebeni" enjalo. Nokho, umzimba wethu yakhelwe ngendlela ukuthi usabela stereotypically njengoba omuhle futhi kususwe ithonya elibi ngaphandle. Ngakho-ke, inkinga yokukhuluphala okwamanje wema ngakho kakhulu.

pathogenesis

WokuLawula idiphozi viva edepho amahwahwa kuqalise ngumuntu ekuhlobaneni okuyinkimbinkimbi phakathi isimiso sezinzwa futhi nezindlala endocrine. Isizathu esikhulu ekuqongeleleni semali lipids kuyinto ukungafani cortex cerebral futhi le ngxenye. Yilapho-ke liyisikhungo ukudla isiqondiso. Umzimba sidinga ukudla ezingaphezu kuka ukusetshenziswa kwamandla kagesi, ngakho yonke ngokweqile ishiywa "zigciniwe", okuholela kwesisindo kanye nesenzakalo lokweqisa adipose izicubu.

Okunjalo abampofu ukubambisana isikhungo kungaba isimo azalwa naso futhi ozotholwa ngokusebenzisa imfundo. Ngaphezu kwalokho, izinkinga ezinjalo ngezinye izikhathi umphumela ukulimala, ukuvuvukala, ezingamahlalakhona endocrine egunjini lokuhlolwa kwezifo.

Lapho indlala pituitary cortex adrenal futhi - amaseli pancreatic ziqala ukubonisa umsebenzi sokugembula kanye nenani ozokusebenzisa incipha ngokucijile, cishe kanye nazo zonke amanoni glucose olunceleka umzimba, kuthiwa imali ezicutshini eziyishumi nemitshingo. Lokhu kuholela iziyaluyalu morphological isibindi, izinso, yegilo.

Ukwahlukanisa BMI

Ukwahlukanisa ukukhuluphala kakhulu ukuba uqale nomunye ukuthi umphakathi ezaziwayo. Njengomthetho, uphethwe eyinhloko yalesi sifo Kwenziwa okusekelwe izinkomba ezifana umzimba mass index (BMI). Lokhu quotient ukubaluleka etholwe emva sokuhlukanisa nesisindo esingaba amakhilogremu by ukuphakama ngamamitha yisikwele. Kukhona ukushiyana kwezidalwa elandelayo ukukhuluphala kule inkomba:

1. kusilela mass - uma BMI kuncane noma elilingana 18,5.
2. Jwayelekile umzimba isisindo - umzimba mass index kufanele ibe uhla 18,5 kuya 25.
3. Oku-okhuluphele - BMI ezisukela amaphuzu 25 kuya ku-30. Kuleli qophelo, it kwandisa ingozi co-morbidities ezifana nomfutho wegazi ophezulu, bedsores futhi inabukeni amawala.
4. Ukukhuluphala wafaka 1 degree lapho BMI kuyinto 30 kuya ku 35.
5. Ukukhuluphala grade 2 - index iseduze amaphuzu 40.
6. Ukukhuluphala grade 3 sitholakale lapho Inkomba umzimba mass mkhulu kunezinhliziyo amaphuzu 40, kuyilapho umuntu has comorbidities.

ngezigaba Etiopatogenetichesky

Ukwahlukaniswa elandelayo ukukhuluphala ingenye enemininingwane kakhulu kule ndawo, ngoba uyakucabangela izimbangela kanye nezindlela zokuthuthukiswa isifo. Ngokusho lokhu ukukhuluphala angawodwa zamabanga aphansi naphezulu. Ngamunye wabo subclasses yayo.

Ngakho, ukukhuluphala eyinhloko uhlukaniswe:
- gluteal-femoral;
- besisu;
- ngenxa yokuphazamiseka kwemikhuba yokudla;
- ukucindezeleka;
- senziwa umzimba syndrome.

Esikhathini yesibili, ukukhuluphala lingaze zingathola subtypes ezine:

1. Ukubambezeleka isakhi sofuzo esinephutha.
2. Cerebral sokucasuka izimila, izifo noma ukulimala kobuchopho sokuhlasela kwamasosha omzimba.
3. Endocrine kubangelwa ukungasebenzi kwekhono ndlala indlala ukulawulwa kohlelo hypothalamic-pituitary nezindlala adrenal futhi gonads.
4. Imithi ephathelene ne-steroid ukuthatha inzalo ama-hormone cytostatics.

ngezigaba Clinico-pathogenetic

Uma sithatha izindlela eziholela ukuvela isisindo okweqile, kungenzeka ukwenza ngezigaba ezifana ukukhuluphala:

- alimentary futhi constitutive. Kwesisindo lihlotshaniswa ngokweqile amafutha ekudleni kanye umzimba. Kubonisa ngokwayo, ngokuvamile ebuntwaneni futhi ingakwazi ukuxhumana nezici ezithile sitholwa njengefa.
- Hypothalamic. Ukwanda izicubu adipose kungenxa umonakalo hypothalamic futhi, ngenxa yalokho, ukuhlukumeza ka neuroendocrine yakhe umsebenzi.
- endocrine. Ngesikhathi enhliziyweni ngamafutha kuyinto zokugula we nezindlala endocrine - the pituitary yegilo, izindlala adrenal.
- Iatrogenic. Ukukhuluphala kubangelwa kokungenela wezokwelapha. Lokhu kungaba imithi, isitho noma ingxenye ukususwa ukulimala kohlelo endocrine e imithi oyinikiwe namanye amaningi.

Kusigaba kwasendaweni kwezicubu adipose

Ngemva ukuhlola iziguli ukukhuluphala kwaphawuleka ukuthi akuwona wonke it is basakaza ngokulinganayo. Ngakho-ke, ngokuhamba kwesikhathi, liye ezifuywa ukukhuluphala ngezigaba esekelwe isici indawo yamafutha amaningi emzimbeni.

Uhlobo lokuqala, eyaziwa nangokuthi engenhla, aka Android, ungachazwa ukuthi ogxile kwandisa engxenyeni engaphezulu umzimba, ubuso, intamo kanye izandla. Kwenzeka kaningi ezingabantu, kodwa kungabonakala nakulokho ku labesifazane abaye baqala ukuya esikhathini. Kunamaphuzu amaningana abalobi uveza ukuthi kukhona ukuhlobana phakathi lolu hlobo ukukhuluphala kanye nengozi yokuba nesifo sikashukela kanye nezifo ze-uhlelo senhliziyo nemithambo yegazi.

Uhlobo lwesibili, phansi noma gynoid iqoqo okunamafutha izicubu emathangeni nezinqe, futhi avame kakhulu ezindaweni isigamu enhle lwesintu. Isibalo abesifazane uthatha uhlobo "ipheya". Futhi ingaqala ebuntwaneni, uma esebenzisa isihluku esephule ukudla okuvamile. Comorbidities kulokhu kuyoba zokugula we emgogodleni, amalunga emikhawulweni aphansi inethiwekhi semithambo.

Uhlobo lwesithathu - ukukhuluphala okuxubile noma Lesisemkhatsini. Kulokhu, isisindo ucishe ngokulinganayo basakaza ngokusebenzisa umzimba by ahlelembe umugqa okhalweni, intamo, izibunu.

Ukuze ukwazi ukubona okuyinto uhlobo ukukhuluphala ngokuthi isiguli, kubalulekile ukucacisa ratio obungazungeza okhalweni kanye okhalweni. Uma abesifazane lesi sibalo sibe sikhulu kunesihlalo 0.85, futhi amadoda obungaphezulu kwento eyodwa, kungashiwo wagomela ukuthi umuntu inguqulo yokuqala ukusatshalaliswa izicubu adipose.

ngezigaba morphological

Nakuba izinguquko ukukhuluphala ezithinta wonke amazinga yenhlangano yokuphila, hhayi nje umzimba sisonke, kodwa futhi izitho ngabanye, izicubu ngisho kumaseli. Adipocytes (amafutha amaseli), kungaba bashintshe qualitative noma ambalwa. Kuye lokhu kukhululwa:

1. ukukhuluphala Hypertrophic. It libhekene Ukwanda okungavamile usayizi amaseli fat, kuyilapho inani labo ayiguquki.
2. ukukhuluphala Hyperplastic, lapho adipocytes ukukhuthalele sokuhlukanisa. Leli fomu kwenzeka ezinganeni iphathwa kabi kakhulu, ngakho indlela yokunciphisa inani lamaseli kungaba izindlela nolaka kakhulu.
3. ukukhuluphala ezixutshiwe njengoba okunengqondo ukucabanga nenye laba ababili odlule. Okungukuthi, abangabantwana maseli hhayi kuphela okwandisa, kodwa iya ngokuya.

Ukwahlukaniswa ukukhuluphala ngokweqile kwezingane

Ngokwezibalo, eRussia kukhona u-12% izingane uhlushwa ukhuluphele. Kulawa, angu-8.5% womphakathi zasemadolobheni kanye 3.5% - yasemakhaya. Nokukhuluphala izingane nentsha isibe pathologies ziyinsakavukela kangangokuba nodokotela bezingane sinqume ukwethula isigaba ekhethekile umsebenzi sako sokufundisa nabazali abasha mayelana nokudla. Ukukhuluphala ubhekwa esimeni lapho isisindo sengane idlula 15% ngenxa yobudala bakhe. Uma kuhlobene nezinga BMI, inani layo kuyoba eduze amaphuzu 30.

Hlukanisa izinhlobo ezimbili ukukhuluphala kwezingane: zamabanga aphansi naphezulu. Primary wakubangela, njengoba umthetho, ukungondleki, ukuyenga ekuseni noma ukwala kusukela ubisi lwebele ukuze inkomo. Kodwa kungaba futhi esidluliselwa ngofuzo, uma umndeni ubuswa abantu abakhuluphele ngokweqile. Kodwa ngisho Kulokhu, umntwana usuke engakabi ozalwa emaningi, nje behlisa ijubane lokugayeka kokudla, futhi nangosizo lokudla okufanele nokuvivinya umzimba okufanele, kuyokugcina isisindo sakho ngaphakathi kwemikhawulo evamile. Ezibucayi ngoba ukukhuluphala eyinhloko kuyizinto zokuqala eminyakeni emithathu zokuphila futhi nokuthomba.

ukukhuluphala Secondary lihlotshaniswa khona atholwe endocrine iziyaluyalu. Lezi zindlela ngawo kunqunywa degree of isethi isisindo okweqile zisekhona debatable. Lesi silinganiso esilandelayo kwahlongozwa:
- 1 degree - isisindo mkhulu kunezinhliziyo 15-25% of wabikezela;
- esiteji 2nd - kusuka 25 kuya 49% kwesisindo;
- 3 degree - mass mkhulu ku 50-99%;
- Grade 4 - ukhuluphele ezikhathini ezimbili noma ngaphezulu mkhulu kunomkhawulo ubudala.

izimpawu

Izimpawu ukukhuluphala ngokuyisisekelo efana nomunye, umehluko kuphela ukufana ukusatshalaliswa fibre ngokweqile, futhi khona pathologies ohambisana noma engekho.

Ngokuvamile kwenzeka iziguli ukukhuluphala alimentary, ukuthi lihlotshaniswa kwephulwe ukudla okuvamile. Njengomthetho, abantu abanjalo yofuzo ukuze kwesisindo, futhi ukusetshenziswa okweqile kuholela ukudla ukuze isisindo somzimba. Izimpawu zenzeka kuwo wonke amalungu omndeni, njengoba sibambane thatha ukudla. Ngaphezu kwalokho, lolu hlobo ukukhuluphala abesifazane babonakala bethambekele abadala abaphila ukuphila umzimba ngenxa yempilo yabo abampofu.

Ukukhuluphala 1 degree ebonwe iningi labantu abadlula njalo, ikakhulukazi kusihlwa. Lokhu kwenzeka ngoba ibhulakufesi futhi kwasemini awunaso isikhathi futhi isifiso. abantu Hungry ekudleni badle ama-kilojoule nsuku zonke futhi alale.

ukukhuluphala Hypothalamic libhekene hhayi kuphela kwesisindo, kodwa futhi khona izimpawu iziyaluyalu isimiso sezinzwa futhi endocrine isiqondiso. Ukukhuluphala likhula ngokushesha futhi ongavamile ukuhlotshaniswa ushintsho ekudleni. Fat livela ogxile phezu phambi esiswini, kwamathanga nezinqe. Kungadala izinguquko trophic: isikhumba esomile, elula amamaki, nezinwele. Lezi ziguli esekhala ukuqwasha, ikhanda kanye nesiyezi. Neurologist kujwayelekile ukubona kwezinso emkhakheni wabo.

ukuhlola

Abantu ukukhuluphala babe ukusola enciphile kakhulu isimo sakhe, ngakho ukuthonya abantu noma ukubaphoqa ukuba ukuya kudokotela ngisho babonisana elula - kungakhathaliseki elula. Kanti kungokunye - Iziguli ezingamadoda endocrinology noma udokotela wezinzwa. Bona abafuni ukuyohlolwa kanye nokunciphisa isisindo ukululama okusheshayo.

Elivame ukusetshenziswa kakhulu umbandela wokuthola sitholakele ukhuluphele - BMI ukukhuluphala. Yileyo ndlela esizwa ngayo isisindo langempela phezu obungenza. Ukuze ubone ukuthi kobukhulu kubaluleke kabi, hhayi kuphela ukufakazela ukuba khona kwamandla isisindo okweqile, kodwa futhi iqiniso ukuthi luyasetshenziswa ngezithukuthuku izicubu adipose, hhayi mass kwemisipha. Ngakho-ke, zokwelapha akhe bazama ngamandla ukwethula izindlela ngokuthé ngqo mass amafutha kunokuba umzimba unamandla nesisindo somzimba Imininingwane.

Norma kunqunywa esekelwe idatha izibalo eqoqwe ngodokotela amakhono ahlukahlukene eminyakeni practice. Ukuze ubulili ngayinye, ubudala, futhi umzimba namazolo kukhona amatafula kakade ukubala amanani kanye nezinkambiso zokugula. Ososayensi baye bathola ukuthi abantu abevile ekhulwini leminyaka isisindo 10% uma kuqhathaniswa nangonyaka evamile. ukukhuluphala okukhwantabalisayo sitholakale kunjalo okuphambene, lapho 10% ngesisindo isidlulile mkhawulo we kuvunyelwe.

Kukhona amafomula eziningana ukubala isisindo umzimba ophelele. Omunye wabo ukwazi zonke izintokazi - kusukela ukukhula isidingo ukuthatha engamakhulu ngamasentimitha. Inombolo ewumphumela ukubaluleka oyifunayo. Kodwa-ke kunemibandela kakhulu futhi cwaningo alithembekile. Okuningi olunembile iyona BMI noma Quetelet Inkomba, eye eboniswe ngenhla. Ukulinganisa obungazungeza okhalweni okhalweni, futhi, kubaluleke kakhulu e kwebalingisi yokukhuluphala, kusukela indawo amanoni incike imbangela, okuyinto kubangelwa isisindo somzimba.

ukwelashwa

Impi yokulwa nokukhuluphala ngokweqile ofundiswa enonya futhi yonke indawo. Manje ezezindaba iqhutshelwe phambili ngendlela enempilo futhi inkolo enhle, umzimba wezemidlalo. Yiqiniso, ukuletha isimo ukuze engenangqondo awubalulekile, kodwa isiqondiso jikelele we ukunyakaza kwentsha luncanyelwa phezu dekadansnaya Yitonia.

Izimiso eziyisisekelo ekwelapheni ukukhuluphala zihlanganisa:
- udle ukudla okune-carbohydrate ayinkimbinkimbi kanye fibre, amavithamini, amantongomane kanye namakhambi. Qiniseka ukuthi ubeke umkhawulo ukubhaka, amaswidi kanye ezinegwebu iziphuzo.
- umsebenzi, okufanele kuqinise umzimba futhi ukusheshisa umzimba.
- imithi ukunciphisa isisindo futhi esesuthi;
- ukwelashwa kwengqondo;
- ukwelashwa kuhlinzwa.

Ukuze kuzuzwe imiphumela yesikhathi eside anoma yiluphi uhlobo lokwelashwa, udinga ukushintsha ekudleni kwakho kanye nokuvama ukudla. Kukholakala ukuthi ukudla kuyize ekulweni ukukhuluphala, kodwa ukusiza ukuqinisa isisindo yafinyelelwa futhi ukuvimbela isifo ukubuya. I-World Health Organization itusa ukuba abale okuqukethwe kwama-kilojoule ukudla ukuthi isiguli isebenzisa kwimodi ejwayelekile, futhi kancane kancane ukunciphisa inani kilojoule. Kuyadingeka ukuba sifinyelele uphawu 1500 - 1200 kcal, inqobo nje uma umuntu angenakho overload ngokwakho ngokwenyama.

Psychotherapy kuhloswe ngazo ukuqinisa ukuzimisela nokuzithiba-maqondana ukudla futhi uncike ukudla okusheshayo soda okunoshukela. Imithi e inqubo isisindo ukunciphisa kusiza sifinyelele kuphela umphumela wangaleso sikhathi. Ngemva ukuqedwa iphilisi, uyabuya isiguli ngendlela yokuphila yesikhathi esidlule, futhi alihambisani izincomo etholwe khulula. Naphezu kweqiniso lokuthi manje abekho embonini yokwenziwa kwemithi ukuze Ukukhetha enkulu ukwelashwa ngalo mnikelo ukhuluphele, cishe bonke of them kungavunyelwe ngenxa yemiphumela emibi.

Ukuze izindlela kuhlinzwa zihlanganisa suturing esiswini, ethandwa e sixties kwekhulu elidlule. Ingqikithi yalo msebenzi ukuthi umzimba ihlukaniswe yaba izingxenye ezimbili ukungalingani, futhi omncane sutured emathunjini amancane. Ngakho, ivolumu esiswini kuyehla, futhi ngesilinganiso ukudlula ukudla kuba ephakeme. Eyesibili inketho - nisishiye siboshwé ngebhande esiswini. Uhlangothi inhliziyo ukukhwezwa indandatho unciphise mafutha anciphisa isikhala esingaphakathi we emphinjeni kanye ukudla ngokuthinta isithiyo yokufakelwa, ecasulayo ukugcwaliswa isikhungo, okuvumela nesineke ukudla kancane.

Hlobo luni ukukhuluphala iyona ayingozi kakhulu? Mhlawumbe wonke. Akukho muntu ongasho ukuthi inzuzo ulusizo abantu. Izinga kobukhulu incike indlela isisindo langempela idlula enhle, futhi yimuphi comorbidities anakho.